Declining Balance Visa Card Agreement I, _____________________________________ acknowledge receipt of a College issued Declining Balance Visa card in the amount of $___________ issued on ______________. (M/D/Y) I understand that I am responsible for obtaining original receipts for all purchases placed using my Declining Balance Visa card. I agree to retain and attach original receipts to the Visa statement that I will be issued by a Works Administrator via my Saint Mary’s email account. I will obtain my Manager’s signature on the statement and submit to the Business Office within fifteen (15) business days of statement issuance. Payroll Deduction Authorization Should I fail to submit my Visa statement with my Manager’s signature and receipts by the required due date, I hereby authorize the deduction from my paycheck for the full Declining Balance Visa card amount stated above. ___________________________________________________________________________ Employee Signature Date